Hypertension

This condition is treated in the Cardiology clinic.

Emergency Referral Criteria

Criteria for Emergency include: 

• Hypertensive emergency (BP greater than 220/140)
• Severe hypertension (systolic BP greater than 180mmHg) with known ischaemic heart disease or cardiomyopathy AND any of the following concerning features:
  • headache
  • confusion
  • blurred vision
  • retinal haemorrhage
  • reduced level of consciousness
  • seizures
  • proteinuria
  • papilloedema
  • signs of heart failure
  • chest pain
• If suspected pregnancy induced hypertension or pre-eclampsia refer patient to the Emergency Department of a facility that offers obstetric services where possible.

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Statewide Referral Criteria (SRC)

Criteria for referral to public hospital specialist clinic services

? Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Urgent (Category 1)

• Severe persistent hypertension (greater than 180/110mmHg but less than 220/140mmHg) in patients with known ischaemic heart disease or cardiomyopathy) without Emergency Referral Criteria concerning features
• Severe persistent hypertension that persists after trial of oral medication as described by the WHO Guideline for the pharmacological treatment of hypertension in adults:

Guideline for the pharmacological treatment of hypertension in adults

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review.

Semi-urgent (Category 2)

• Hypertensive medication intolerance
• Suspected renal artery stenosis, noting this may be on-referred to Vascular
• Refractory hypertension (greater than 140/90mmHg but less than 180/110mmHg) in patients with known ischaemic heart disease or cardiomyopathy and receiving 3 or more antihypertensive agents

Routine (Category 3)

• Changing pattern of hypertension

Information to be included in the referral 

(referral may be returned without this)

Essential supporting information

Pathology

• FBC
• UEC
• LFTs
• eGFR
• lipid results (cholesterol, TG, HDL, LDL)
• Urinalysis results
• Urinary protein estimation results or albumin creatinine ratio

Imaging

• Chest x-ray report

Investigations/Other

• ECG
• BP (BP measurements on both arms preferable)

Additional information

• Details of relevant signs and symptoms
• Details of all treatments offered and efficacy
• Relevant previous medical history and co-morbidities

Interim/GP management

To refer a patient with this condition, please see the Cardiology clinic page for the full referral process and templates.

Additional information which may assist triage:

• Any investigations relevant to co-morbidities
• Stress test report (if available)
• Renal duplex report if renal artery stenosis suspected
• History of smoking, alcohol intake and drug use (including recreational drugs

Interim management advice for Hypertension can be found on HealthPathways Tasmania.

For more information please see the HealthPathways Tasmania

Additional resources

View all clinic availability